Blood test could soon provide PTSD diagnosis

The Veterans Health Administration estimates it will treat nearly six million patients this year, including more than 260,000 veterans from the wars in Iraq and Afghanistan. The most common mental health problem suffered by those troops is post-traumatic stress disorder, known as PTSD. There is aggressive research underway at the San Francisco Veteran's Medical Center, where scientists from UCSF are looking for changes in the blood and the brain to find treatments for victims of PTSD.

More than 20 percent of the troops who fought in the Iraq and Afghanistan wars may be diagnosed with mental health problems known as PTSD. That has prompted Congress to authorize $900 million for research into PTSD and brain trauma.

That research could one day allow PTSD to be diagnosed through a blood test or a brain scan, like most other diseases. It could end up motivating thousands of vets to get treatment.

"I want to see if I can come up with a profile that might look at the biological reason for PTSD," said Dr. Lynn Pulliam, director of research at San Francisco V.A. Medical Center.

The San Francisco V.A. Medical Center works with NCIRE (Northern California Institute for Research and Education). They have more than 200 doctors affiliated with UCSF and Ph.D. investigators all working under the same roof. It is the largest research program of its kind in the V.A. system.

"You have psychiatrists, basic research, radiologists, neuro-imaging. This is very unusual to have this type of multidisciplinary approach to one particular disease," said Dr. Pulliam.

The research program has a huge sense of urgency. Thousands of soldiers are still at war, and thousands of others are already home, suffering and worried they will be judged as being weak if they ask for help.

"When we learn more about the biology of PTSD, I think this will help with stigma," said Dr. Thomas Neylan, head of the PTSD program at the San Francisco V.A. Medical Center.

Dr. Neylan says a biological diagnosis would be very different than the current method.

"PTSD is a diagnosis made entirely based on an interview or measures of people, subjective rating of symptoms," said Dr. Neylan.

He says the symptoms can include:

Being haunted by memories of the war

Always feeling like they're on guard

Trouble with irritability and anger

Isolating themselves from others

Having nightmares which disrupt their sleep

"We're doing several sleep studies," said Dr. Neylan who is inviting vets to participate in studies on how the lack of sleep affects them. "One is looking at the role of stress hormones that might be implicated in sustaining chronic insomnia with people with PTSD. In this study, we're also looking at the interaction of stress hormones with certain measures of general health."

Physicist Norbert Shuff is one of the researchers looking at whether PTSD causes changes in the brain. A powerful MRI machine is revealing some startling information in one of the studies.

"We're not seeing it yet in individual subjects, but we do compare a group of post-traumatic stress people to normals -- we see systematic differences," said Dr. Shuff. "Those differences are mainly reductions in brain size in these particular spots in the brain."

The research being done at the V.A. Medical Center to help veterans could eventually apply to the general population because anybody who has had a life-threatening situation or a deeply traumatic incident could have PTSD.

"People in emergency services want to know how can you help somebody who's been traumatized, somebody who comes in and was raped, or assaulted, or terrified in a motor vehicle accident," said Dr. Neylan.

So NCIRE and the San Francisco V.A. Medical Center are urging all local vets to come in for treatment and consider joining the research studies.

We asked Dr. Pulliam about the perception that it is hard for vets to get into treatment.

"Not here, not here," said Dr. Pulliam. "We are aware of their issues and we are ready to take care of them."

For more on PTSD, including a list of resources for veterans and their families, read The Back Story.